important issues in behavioral healthcareFour years after the passage of the ACA and seven years after the first Mental Health Parity bill was passed, there is still much work to do, stated Paul Samuels and Gabrielle de la Gueronniere of the Legal Action Center in their presentation on “Health Reform Impact: Parity, Essential Health Benefits, and Network Adequacy”.

The ACA and Parity legislation have been implemented together, although mental health parity is required in all states, whereas the ACA is highly variable from state to state. The upshot is that implementation in some states is driven more by politics than by best practices and public health.

These disparities, the pair contended, require “grass-roots advocacy” and “watchdogs” among state advocates, who are urged to record specific obstacles to obtaining adequate care for their clients and patients.

The Whole Health Coalition, a 100-member advocacy group in which they are leaders, has prepared an advocacy survey for use in the states, and has created a forum for collecting examples and stories of state, agency, and insurer abuse or misinterpretation of the laws. Through such programs, consumers and clinicians can be the observers and reporters of the progress on health reform efforts.

As we have seen at, the speakers noted, people at the top tell us everything is working fine. But we all know that it is not, so we must ask “Is the system being set up to do what it ought to do?” If not, we need to speak up and plug into the political and clinical outlets that have been created on the front lines.

Can we clinical social workers find ways to advocate for system change with as much commitment as we bring to helping our clients with their own life-changes?




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